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5.
Medicine (Baltimore) ; 99(8): e19167, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080095

RESUMO

To verify the validity of functional health literacy scale and analyze what influences functional health literacy.Using convenience sampling method based on cross-sectional data to select 589 left-behind senior high-school students in an ethnic minority area, using the functional health literacy scale.The scale results were relatively strong, and the absolute fitness index, value-added fitness index, and simple fitness index reached the fitness standards. The overall functional health literacy score was (0.65 ±â€Š0.12), which falls within the upper middle class. Gender(t = 2.40, P < .05), ethnicity (t = 4.28, P < .001), place of residence (t =  = 4.51, P < .001), mother's education level (F = 3.608, P < .05), self-assessment of grades for 1 year (F = 25.781, P < .001), and whether the participant liked the health education content (F = 9.416, P < .001) had impacts on overall functional health literacy.The study results show that relatively satisfactory reliability and validity and can be applied further analysis for improving students functional health literacy levels.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Alfabetização em Saúde/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Inquéritos e Questionários/normas , Sucesso Acadêmico , Adolescente , China/epidemiologia , Estudos Transversais , Feminino , Educação em Saúde/estatística & dados numéricos , Humanos , Masculino , Reprodutibilidade dos Testes , República da Coreia/etnologia , Características de Residência/estatística & dados numéricos , População Rural/estatística & dados numéricos , Fatores Sexuais
6.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46948

RESUMO

La Región de las Américas se caracteriza por ser multiétnica y multicultural. En ella coexisten los pueblos indígenas, los afrodescendientes, los romaníes y los miembros de otros grupos étnicos, lo que implica reconocer diversas realidades y necesidades en el ámbito de la salud.


Assuntos
Grupos Étnicos , Grupos Minoritários
7.
JAMA Netw Open ; 3(1): e1919928, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31995211

RESUMO

Importance: An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space. Objectives: To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois. Design, Setting, and Participants: In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n = 71 901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsupervised algorithms used to reduce dimensions of multivariate data). The SDOH indices were used to estimate age-adjusted mortality rates in Chicago (n = 789 census tracts with approximately 7.5 million persons) with a spatial regression for the same period, while controlling for violent crime. Main Outcomes and Measures: Fifteen variables, measured as a 5-year mean, were selected to characterize SDOH as small-area variations for demographic characteristics of vulnerable groups, economic status, social and neighborhood characteristics, and housing and transportation availability at the census-tract level. This SDOH data matrix was reduced to 4 indices reflecting advantage, isolation, opportunity, and mixed immigrant cohesion and accessibility, which were then clustered into 7 distinct multidimensional neighborhood typologies. The association between SDOH indices and premature mortality (defined as death before age 75 years) in Chicago was measured by years of potential life lost and aggregated to a 5-year mean. Data analyses were conducted between July 1, 2018, and August 30, 2019. Results: Among the 71 901 census tracts examined across the continental United States, a median (interquartile range) of 27.2% (47.1%) of residents had minority status, 12.1% (7.5%) had disabilities, 22.9% (7.6%) were 18 years and younger, and 13.6% (8.1%) were 65 years and older. Among the 789 census tracts examined in Chicago, a median (interquartile range) of 80.4% (56.3%) of residents had minority status, 10.2% (8.2%) had disabilities, 23.2% (10.9%) were 18 years and younger, and 9.5% (7.1%) were 65 years and older. Four SDOH indices accounted for 71% of the variance across all census tracts in the continental United States in 2014. The SDOH neighborhood typology of extreme poverty, which is of greatest concern to health care practitioners and policy advocates, comprised only 9.6% of all census tracts across the continental United States but characterized small areas of known public health crises. An association was observed between all SDOH indices and age-adjusted premature mortality rates in Chicago (R2 = 0.63; P < .001), even after accounting for violent crime and spatial structures. Conclusions and Relevance: The modeling of SDOH as multivariate indices rather than as a singular deprivation index may better capture the complexity and spatial heterogeneity underlying SDOH. During a time of increased attention to SDOH, this analysis may provide actionable information for key stakeholders with respect to the focus of interventions.


Assuntos
Nível de Saúde , Grupos Minoritários/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Idoso , Chicago , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Qualidade de Vida , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
9.
BJOG ; 127(5): 600-608, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31986555

RESUMO

OBJECTIVES: To explore obstetricians' and gynaecologists' experiences of work-related traumatic events, to measure the prevalence and predictors of post-traumatic stress disorder (PTSD), any impacts on personal and professional lives, and any support needs. DESIGN: Mixed methods: cross-sectional survey and in-depth interviews. SAMPLE AND SETTING: Fellows, members and trainees of the Royal College of Obstetricians and Gynaecologists (RCOG). METHODS: A survey was sent to 6300 fellows, members and trainees of RCOG. 1095 people responded. Then 43 in-depth interviews with trauma-exposed participants were completed and analysed by template analysis. MAIN OUTCOME MEASURES: Exposure to traumatic work-related events and PTSD, personal and professional impacts, and whether there was any need for support. Interviews explored the impact of trauma, what helped or hindered psychological recovery, and any assistance wanted. RESULTS: Two-thirds reported exposure to traumatic work-related events. Of these, 18% of both consultants and trainees reported clinically significant PTSD symptoms. Staff of black or minority ethnicity were at increased risk of PTSD. Clinically significant PTSD symptoms were associated with lower job satisfaction, emotional exhaustion and depersonalisation. Organisational impacts included sick leave, and 'seriously considering leaving the profession'. 91% wanted a system of care. The culture in obstetrics and gynaecology was identified as a barrier to trauma support. A strategy to manage the impact of work-place trauma is proposed. CONCLUSIONS: Exposure to work-related trauma is a feature of the experience of obstetricians and gynaecologists. Some will suffer PTSD with high personal, professional and organisational impacts. A system of care is needed. TWEETABLE ABSTRACT: 18% of obstetrics and gynaecology doctors experience post-traumatic stress disorder after traumatic events at work.


Assuntos
Ginecologia , Obstetrícia , Estresse Ocupacional/epidemiologia , Médicos/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Esgotamento Profissional/epidemiologia , Fadiga por Compaixão/epidemiologia , Estudos Transversais , Despersonalização , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Licença Médica , Inquéritos e Questionários , Reino Unido/epidemiologia
11.
Gastroenterology ; 158(2): 354-367, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31682851

RESUMO

Colorectal cancer (CRC) disproportionately affects people from low socioeconomic backgrounds and some racial minorities. Disparities in CRC incidence and outcomes might result from differences in exposure to risk factors such as unhealthy diet and sedentary lifestyle; limited access to risk-reducing behaviors such as chemoprevention, screening, and follow-up of abnormal test results; or lack of access to high-quality treatment resources. These factors operate at the individual, provider, health system, community, and policy levels to perpetuate CRC disparities. However, CRC disparities can be eliminated. Addressing the complex factors that contribute to development and progression of CRC with multicomponent, adaptive interventions, at multiple levels of the care continuum, can reduce gaps in mortality. These might be addressed with a combination of health care and community-based interventions and policy changes that promote healthy behaviors and ensure access to high-quality and effective measures for CRC prevention, diagnosis, and treatment. Improving resources and coordinating efforts in communities where people of low socioeconomic status live and work would increase access to evidence-based interventions. Research is also needed to understand the role and potential mechanisms by which factors in diet, intestinal microbiome, and/or inflammation contribute to differences in colorectal carcinogenesis. Studies of large cohorts with diverse populations are needed to identify epidemiologic and molecular factors that contribute to CRC development in different populations.


Assuntos
Neoplasias Colorretais/epidemiologia , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer/estatística & dados numéricos , Acesso aos Serviços de Saúde , Estilo de Vida Saudável , Humanos , Incidência , Programas de Rastreamento/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Fatores de Risco
12.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 56-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31123058

RESUMO

OBJECTIVE: To describe ethnic and socioeconomic variation in cause-specific infant mortality of preterm babies by gestational age at birth. DESIGN: National birth cohort study. SETTING: England and Wales 2006-2012. SUBJECTS: Singleton live births at 24-36 completed weeks' gestation (n=256 142). OUTCOME MEASURES: Adjusted rate ratios for death in infancy by cause (three groups), within categories of gestational age at birth (24-27, 28-31, 32-36 weeks), by baby's ethnicity (nine groups) or area deprivation score (Index of Multiple Deprivation quintiles). RESULTS: Among 24-27 week births (5% of subjects; 47% of those who died in infancy), all minority ethnic groups had lower risk of immaturity-related death than White British, the lowest rate ratios being 0.63 (95% CI 0.49 to 0.80) for Black Caribbean, 0.74 (0.64 to 0.85) for Black African and 0.75 (0.60 to 0.94) for Indian. Among 32-36 week births, all minority groups had higher risk of death from congenital anomalies than White British, the highest rate ratios being 4.50 (3.78 to 5.37) for Pakistani, 2.89 (2.10 to 3.97) for Bangladeshi and 2.06 (1.59 to 2.68) for Black African; risks of death from congenital anomalies and combined rarer causes (infection, intrapartum conditions, SIDS and unclassified) increased with deprivation, the rate ratios comparing the most with the least deprived quintile being, respectively, 1.54 (1.22 to 1.93) and 2.05 (1.55 to 2.72). There was no evidence of socioeconomic variation in deaths from immaturity-related conditions. CONCLUSIONS: Gestation-specific preterm infant mortality shows contrasting ethnic patterns of death from immaturity-related conditions in extremely-preterm babies, and congenital anomalies in moderate/late-preterm babies. Socioeconomic variation derives from congenital anomalies and rarer causes in moderate/late-preterm babies. Future research should examine biological origins of extremely preterm birth.


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Mortalidade Infantil/etnologia , Recém-Nascido Prematuro , Grupos Minoritários/estatística & dados numéricos , Pobreza , Causas de Morte , Estudos de Coortes , Anormalidades Congênitas/mortalidade , Inglaterra/epidemiologia , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/mortalidade , País de Gales/epidemiologia
13.
J Stroke Cerebrovasc Dis ; 29(1): 104466, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31734125

RESUMO

BACKGROUND: Medical mistrust influences patients' treatment seeking, adherence, health behaviors, and minority participation in research studies. However, medical mistrust remains understudied within neurological diseases like stroke despite disproportionately affecting minority populations. OBJECTIVE: This study examines the relationship of medical mistrust with stroke knowledge among Black, Latino, Korean, and Chinese-Americans. METHODS: Subjects greater than 60 years were enrolled from senior centers to test a culturally-tailored educational curriculum around stroke risk reduction in a randomized controlled trial. A Trust Physician Scale and a modified Trust of Medical Researchers Scale measured medical mistrust. The Stroke Action Test instrument measured stroke knowledge, focusing on intent to call 911 appropriately when presented with stroke symptoms. RESULTS: Of 225 subjects, 69.5% were female (n = 157) with an average age of 73.7 years (standard deviation 6.7). Blacks had highest trust scores of physicians relative to Latino/a, Korean or Chinese subjects (P< .05). In multivariable analysis, decreased stroke knowledge was associated with decreased researcher trust at baseline (<.05), but not physician trust, when controlling for covariates. Among Latino/a, Korean, and Chinese groups, mainstream acculturation reduced the association between researcher trust and stroke knowledge. A mediation model showed no evidence of physician trust mediating researcher trust. CONCLUSIONS: Among minority seniors participating in a randomized controlled trial, decreased trust of researchers, not physicians, was associated with low baseline knowledge of stroke symptoms. Those least acculturated to US culture may be a particular focus for trust building intervention. Future studies should examine whether researcher mistrust is disproportionately preventing those with the largest knowledge gaps from participating in trials.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Grupos Minoritários/psicologia , Educação de Pacientes como Assunto/métodos , Serviços Preventivos de Saúde , Relações Profissional-Paciente , Pesquisadores/psicologia , Sujeitos da Pesquisa/psicologia , Acidente Vascular Cerebral/prevenção & controle , Confiança , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/etnologia , Envelhecimento/psicologia , Atitude do Pessoal de Saúde , Estudos Transversais , Características Culturais , Assistência à Saúde Culturalmente Competente/etnologia , Currículo , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/psicologia
15.
Nurs Educ Perspect ; 41(1): 46-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860488

RESUMO

Unequal representation of black nurses in the workforce continues to plague the nursing profession. Preconceptions and understandings of the discipline are underpinned by the dominant white racial makeup, which may challenge ethnically diverse nursing students' perceptions of their ability for success. The need for a diverse nursing workforce includes the challenge of enticing minority students into and successfully through prelicensure programs. This study of attributes of grit in the lived experiences of black nursing students revealed evidence including consistent efforts and perseverance to reach goals in the participants' stories.


Assuntos
Afro-Americanos , Bacharelado em Enfermagem , Estudantes de Enfermagem , Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Europeu , Humanos , Grupos Minoritários , Estudantes de Enfermagem/psicologia
16.
J Surg Res ; 245: 198-204, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31421362

RESUMO

BACKGROUND: Race and insurance status have been shown to predict outcomes in pediatric bicycle traumas. It is unknown how these factors influence outcomes in adult bicycle traumas. This study aims to evaluate the association, if any, between race and insurance status with mortality in adults. METHODS: This retrospective cohort study used the National Trauma Data Bank Research Data Set for the years 2013-2015. Multivariate logistic regression models were used to determine the independent association between patient race and insurance status on helmet use and on outcomes after hospitalization for bicycle-related injury. These models adjusted for demographic factors and comorbid variables. When examining the association between race and insurance status with outcomes after hospitalization, injury characteristics were also included. RESULTS: A study population of 45,063 met the inclusion and exclusion criteria. Multivariate regression demonstrated that black adults and Hispanic adults were significantly less likely to be helmeted at the time of injury than white adults [adjusted odds ratio of helmet use for blacks 0.25 (95% CI 0.22-0.28) and for Hispanics 0.33 (95% CI 0.30-0.36) versus whites]. Helmet usage was also independently associated with insurance status, with Medicare-insured patients [AOR 0.51 (95% CI 0.47-0.56) versus private-insured patients], Medicaid-insured patients [AOR 0.18 (95% CI 0.17-0.20)], and uninsured patients [AOR 0.29 (95% CI 0.27-0.32)] being significantly less likely to be wearing a helmet at the time of injury compared with private-insured patients. Although patient race was not independently associated with hospital mortality among adult bicyclists, we found that uninsured patients had significantly higher odds of mortality [AOR 2.02 (AOR 1.31-3.12)] compared with private-insured patients. CONCLUSIONS: Minorities and underinsured patients are significantly less likely to be helmeted at the time of bicycle-related trauma when compared with white patients and those with private insurance. Public health efforts to improve the utilization of helmets during bicycling should target these subpopulations.


Assuntos
Ciclismo/lesões , Disparidades em Assistência à Saúde/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Conjuntos de Dados como Assunto , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Escala de Gravidade do Ferimento , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos/epidemiologia , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/terapia , Adulto Jovem
18.
BMC Public Health ; 19(1): 1722, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870346

RESUMO

BACKGROUND: To reveal the ethnic disparity in the pneumonia-specific mortality rates of children under the age of 5 years (PU5MRs) and provide suggestions regarding priority interventions to reduce preventable under-five-years-of-age deaths. METHODS: Data were obtained from the Direct Report System of Maternal and Child Health in Sichuan. The Cochran-Armitage trend test was used to assess the time trend. The Cochran-Mantel-Haenszel test and Chi-square test were used to examine the differences in the PU5MRs among different groups. RESULTS: The PU5MRs in the minority and nonminority counties decreased by 53.7 and 42.3% from 2010 to 2017, respectively. The PU5MRs of the minority counties were 4.81 times higher than those of the nonminority counties in 2017. The proportion of pneumonia deaths to total deaths in Sichuan Province increased from 11.7% in 2010 to 15.5% in 2017. The pneumonia-specific mortality rates of children in the categories of 0-28 days, 29 days-11 months, and 12-59 months were reduced by 55.1, 38.8, and 65.5%, respectively, in the minority counties and by 35.5, 43.1, and 43.7%, respectively, in the nonminority counties. CONCLUSIONS: PU5MRs declined in Sichuan, especially in the minority counties, while ethnic disparity still exists. Although the PU5MRs decreased more for the minority counties as a fraction of all mortality, the absolute number of such deaths were higher, and therefore more children in these counties continue to die from pneumonia than from the non-minority counties. Priority should be given to strategies for preventing and controlling child pneumonia, especially for postneonates, in the minority counties.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Grupos Minoritários/estatística & dados numéricos , Pneumonia/etnologia , Pneumonia/mortalidade , Distribuição de Qui-Quadrado , Pré-Escolar , China/epidemiologia , Humanos , Lactente , Recém-Nascido
19.
BMC Public Health ; 19(1): 1741, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881953

RESUMO

BACKGROUND: While discrimination takes multiple forms, racial or ethnic discrimination is a root cause of this health-damaging social phenomenon. We drew on intersectionality theory, which offers an account of discrimination's multiple effects, to consider associations between women's experiences of discrimination and postpartum depression (PPD) using four measures: single forms of discrimination (SFD); multiple forms of discrimination (MFD); ethnic discrimination combined with MFD (E-MFD); and a composite MFD that interacted with women's identity (C-MFD). METHODS: We interviewed a stratified sample of 1128 mothers face to face in 2014-2015 during mothers' visits to maternal and child health clinics. The mothers belonged to three groups in Israel: Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish. We conducted unadjusted and adjusted logistic regressions for PPD, measured on the Edinburgh Postnatal Depression Scale, in associations with SFD (experiencing discrimination based on any of the following: age, sex, class, ethno-national identity, religiosity level and skin color); MFD (experiencing 0,1, 2 or ≥ 3 of SFD); E-MFD (ethnic discrimination combined with other MFD); and finally, C-MFD (interaction between MFD and women's identity). RESULTS: Palestinian-Arab mothers had higher PPD and reported higher SFD (based on ethnicity, religiosity level, and socioeconomic status), as well as higher MFD and E-MFD. This was followed by Jewish immigrant mothers, and lastly by non-immigrant Jewish mothers. However, both MFD and E-MFD had a strong association with PPD among non-immigrant Jewish mothers reporting 2MFD and ≥ 3MFD, and Palestinian-Arab mothers reporting ≥3MFD, but no significant association among immigrant Jewish mothers. When we used C-MFD, we found a dose-response association in which Palestinian-Arab mothers experiencing more MFD (2MFD and ≥ 3MFD) were more likely to experience PPD. This was followed by immigrant Jewish mothers (reporting 2MFD and ≥ 3MFD), and lastly by non-immigrant Jewish mothers. CONCLUSIONS: MFD should be considered in relation to women's identity (being part of a minority, immigrant, or non-immigrant majority group) in maternal mental health research and practice. Otherwise, we risk underestimating the effects of MFD on PPD, especially in minority and immigrant mothers, who are more likely to face interlocking forms of discrimination.


Assuntos
Árabes/psicologia , Depressão Pós-Parto/etnologia , Emigrantes e Imigrantes/psicologia , Judeus/psicologia , Grupos Minoritários/psicologia , Mães/psicologia , Preconceito/etnologia , Adolescente , Adulto , Árabes/estatística & dados numéricos , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Israel , Judeus/estatística & dados numéricos , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Mães/estatística & dados numéricos , Adulto Jovem
20.
Cuad. bioét ; 30(100): 253-262, sept.-dic. 2019.
Artigo em Espanhol | IBECS | ID: ibc-185239

RESUMO

El concepto de vulnerabilidad ha determinado múltiples actuaciones en el ámbito sanitario. En los últimos años este concepto ha originado diversos modelos holísticos que oscilan entre considerar la vulnerabilidad como un elemento descriptivo de una situación accidental hasta su consideración como principio orientador de la práctica médica. Se percibe la necesidad de profundizar en este fenómeno desde el punto de vista de la filosofía moral. La reflexión moral revela un desequilibrio en el binomio autonomía-dependencia, generando soluciones opuestas en la toma de decisiones. Aunque la autonomía ha fundamentado hasta ahora gran parte de la acción médica, la dependencia plantea una nueva óptica sobre la vulnerabilidad, ra-dicada en la ética del cuidado. Esta perspectiva permite superar la consideración de la vulnerabilidad como una característica, un accidente o un principio. La vulnerabilidad aparece como una dimensión intrínseca del ser humano que, lejos de alterar su dignidad o su autonomía, permite evidenciar la necesidad de los otros para alcanzar su plenitud


The concept of vulnerability has determined multiple actions in the health field. In recent years, this concept has originated various holistic models that oscillate between considering vulnerability as a descriptive element of an accidental situation until it is considered a guiding principle of medical practice. The need to deepen this phenomenon from the point of view of moral philosophy is perceived. The moral reflection reveals an imbalance in the binomial autonomy-dependence, generating opposite solutions in decision-making. Although autonomy has so far supported much of the medical action, the dependency raises a new perspective on vulnerability, rooted in the ethics of care. This perspective allows us to overcome the consideration of vulnerability as a characteristic, an accident or a principle. Vulnerability appears as an intrinsic dimension of the human being that, far from altering its dignity or autonomy, makes it possible to demonstrate the need of others to reach their fullness


Assuntos
Humanos , Vulnerabilidade Social , Bioética , Nível de Saúde , Grupos Minoritários , Saúde das Minorias/ética , Pobreza , Ética Baseada em Princípios , Populações Vulneráveis , Grupos de Risco , Autonomia Pessoal , Deambulação com Auxílio/ética , Indigência Médica , Responsabilidade Social
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